University of Toronto, Toronto, Ontario, Canada.
ICES, Toronto, Ontario, Canada.
Arthritis Care Res (Hoboken). 2023 Feb;75(2):317-325. doi: 10.1002/acr.24781. Epub 2022 Sep 27.
To investigate the incidence of and factors associated with SARS-CoV-2 testing and infection in immune-mediated inflammatory disease (IMID) patients versus matched non-IMID comparators from the general population.
We conducted a population-based, matched cohort study among adult residents from Ontario, Canada, from January 2020 to December 2020. We created cohorts for the following IMIDs: rheumatoid arthritis (RA), psoriasis, psoriatic arthritis, ankylosing spondylitis, systemic autoimmune rheumatic diseases, multiple sclerosis (MS), iritis, inflammatory bowel disease (IBD), polymyalgia rheumatica, and vasculitis. Each patient was matched with 5 patients without IMIDs based on sociodemographic factors. We estimated the incidence of SARS-CoV-2 testing and infection in IMID patients and non-IMID patients. Multivariable logistic regressions assessed odds of SARS-CoV-2 infection.
We studied 493,499 patients with IMIDs and 2,466,946 patients without IMIDs. Patients with IMIDs were more likely to have at least 1 SARS-CoV-2 test versus patients without IMIDs (27.4% versus 22.7%), but the proportion testing positive for SARS-CoV-2 was identical (0.9% in both groups). Overall, IMID patients had 20% higher odds of being tested for SARS-CoV-2 (odds ratio 1.20 [95% confidence interval 1.19-1.21]). The odds of SARS-CoV-2 infection varied across IMID groups but was not significantly elevated for most IMID groups compared with non-IMID comparators. The odds of SARS-CoV-2 infection was lower in IBD and MS and marginally higher in RA and iritis.
Patients across all IMIDs were more likely to be tested for SARS-CoV-2 versus those without IMIDs. The risk of SARS-CoV-2 infection varied across disease subgroups.
调查免疫介导的炎症性疾病（IMID）患者与来自普通人群的匹配非-IMID 对照者相比，SARS-CoV-2 检测和感染的发生率及相关因素。
我们在 2020 年 1 月至 12 月期间，对加拿大安大略省的成年居民进行了一项基于人群的匹配队列研究。我们创建了以下 IMID 的队列：类风湿关节炎（RA）、银屑病、银屑病关节炎、强直性脊柱炎、系统性自身免疫性风湿病、多发性硬化症（MS）、虹膜炎、炎症性肠病（IBD）、巨细胞动脉炎和血管炎。每位患者根据社会人口统计学因素与 5 名无 IMID 的患者相匹配。我们估计了 IMID 患者和非-IMID 患者中 SARS-CoV-2 检测和感染的发生率。多变量逻辑回归评估了 SARS-CoV-2 感染的几率。
我们研究了 493499 名 IMID 患者和 2466946 名无 IMID 患者。与无 IMID 患者相比，IMID 患者更有可能至少进行 1 次 SARS-CoV-2 检测（27.4%对 22.7%），但 SARS-CoV-2 检测阳性的比例相同（两组均为 0.9%）。总体而言，IMID 患者进行 SARS-CoV-2 检测的几率高 20%（比值比 1.20 [95%置信区间 1.19-1.21]）。SARS-CoV-2 感染的几率因 IMID 组而异，但与非-IMID 对照组相比，大多数 IMID 组的感染几率并未显著升高。与非-IMID 对照组相比，IBD 和 MS 患者感染 SARS-CoV-2 的几率较低，而 RA 和虹膜炎患者感染 SARS-CoV-2 的几率略高。
与无 IMID 的患者相比，所有 IMID 患者更有可能接受 SARS-CoV-2 检测。SARS-CoV-2 感染的风险因疾病亚组而异。
